High-dose prophylactic anticoagulation benefits patients with COVID-19 pneumonia. medtwitter COVID
March 30, 2023
Previous studies of different anticoagulation strategies for noncritically ill and critically ill patients with COVID-19 pneumonia have shown contrasting results, but some institutions recommend a high-dose regimen in the wake of data showing macrovascular thrombosis in patients with COVID-19 who were treated with standard anticoagulation, the authors wrote.
For the primary outcome, results were similar among the groups; HD-PA had no significant benefit over SD-PA or TA. All-cause death rates for SD-PA, HD-PA, and TA patients were 14%, 12%, and 13%, respectively. The time to clinical improvement for the three groups was approximately 8 days, 9 days, and 8 days, respectively. Results for the primary outcome were consistent across all prespecified subgroups.
The findings were limited by several factors including the open-label design and the relatively small sample size, the lack of data on microvascular thrombosis at baseline, and the predominance of the Delta variant of COVID-19 among the study participants, which may have contributed to a lower mortality rate, the researchers noted.
In the current study,"It was notable that the primary driver of the improved outcomes with the 'high-dose' prophylactic regimen reflected the fourfold reduction in macrovascular thrombosis, a finding which was not observed in other studies investigating anticoagulant therapy in hospitalized patients with severe COVID-19," Ortel told Medscape.
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